Recently I had to handle a situation for a client when the workers' compensation insurance company denied treatment for migraine headaches caused by medication given to my client by an authorized physician.
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Although Georgia's workers' compensation system is supposed to foster an environment where legitimately injured workers can get needed treatment and then return to work, the reality is much different. It has been my experience that workers' compensation practice is just about as adversarial as divorce practice. Often justice and fair play take a back seat to "winning" and efforts by employers insurance companies to avoid paying benefits.
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As I was loading a 400lb. piece of freight on an aircraft, my (L) knee twisted. I was sent to a clinic and evaluated that I might need a knee replacement. I have a history of several knee surgeries, my job function is loading and unloading airplanes for 30 years. My question is can I obtain my own Dr. in the state of Ga., under the workmans compensation laws………Thanks
–Andrew
Jodi Ginsberg responds: Andrew, thanks for your interesting question. Here is how I would analyze your situation. First, I would want to know if your potential need for a knee replacement is the result of your most recent injury or is it a combination of this injury and your past injuries/surgeries?
Your employer and its insurer may try to argue that your current problem is the result of past injuries as opposed to this incident, and they may try to deny coverage.
Even if your employer tries to deny coverage based on your old knee problems, your case may be winnable if a treating doctor will go on record that your most recent injury aggrevated your pre-existing condition, and if you did not misrepresent your knee problems at the time you were hired.
If your employer has accepted responsibility for covering your knee problem, then the next step would be to get you to a specialist. Under Georgia's workers' compensation law, an authorized treating doctor can refer you to a specialist and, generally, the insurer would be responsible for paying the specialist to treat you. If your employer has a valid "posted panel of physicians" there may be a specialist there that you could choose.
If the employer is denying coverage, you would need to request a hearing on the issue of whether your injury is compensable.
As you can see, the answer to your question depends on a number of factors. I do not think you can or should assume that your employer or its workers' compensation carrier will act in your best interest.
Feel free to call me at 770-351-0801 if you wish to discuss further.
Technorati Tags: knee injury and georgia workers compensation, arising out of and in the course of employment, pre-existing condition and workers compensation
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I wanted to know if there was anything that could be done to help me. I had surgery on my left shoulder and have reached MMI with a disability rating and significant work/lifting restrictions (I'm a nurse). Now, my right arm is starting to grind and bother me. I know it's from overuse of it because I had no problems with it until I kept having surgeries on my left (3) and had to use it all the time. Is this a part of my workers comp. claim or do I have to be on my own with this?
Sonji
Jodi Ginsberg replies: Sonji, he injury to your right arm is potentially compensible as part of your workers' compensation claim. If your authorized treating physician will agree that the problems you are having with your right arm are consistent with overuse that is reasonably and logically the result of having only one functioning arm then you have a strong argument for benefits.
Technorati Tags: arising out of the course of employment, georgia workers compensation, overuse syndrome
North Carolina workers' compensation lawyer Dan Deuterman recently wrote about one of his cases, Clark vs. WalMart, that ended up in the North Carolina Supreme Court. Although the Clark case arose under North Carolina law, there are implications for Georgia workers' compensation claimants.
More on New Job Injury Triggers Related Medical Problems – What is Compensable?
I would like some info. I was injured on the job last week. Actually I broke my foot while working in the woods. My employer said to present him a bill and he will pay instead of filing workers comp. Who is that benefiting he or I? I have since worked everyday just limping along. It hurts alot, but I have a family and cannot miss a paycheck. If he doesnt pay the bills what should I do, or should I do something now? Please advice.
–Edgar
More on Employer Does Not Want Me to File My Injury Claim Under Workers' Comp. Is This a Good Idea?
As a rule, if you are injured traveling to or from work, you are not covered by Georgia workers' compensation. However, there is an exception to this rule. These exceptions include:
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